Monday, April 11

Dr. Marla Shapiro: The Momterview

{Update: In April 2012, Dr. Marla's daughter Amanda tragically passed away at the age of 25 from a sudden and unexpected illness. She died in Cambridge, England where she was studying.}

Dr. Marla Shapiro is a well-loved Canadian physician, known for her role as a guest medical expert on various news programs, and her own television show Balance. She also shared a very private side of herself with her book "Life in the Balance: My Journey with Breast Cancer", and corresponding documentary "Run Your Own Race".

We may call her "Dr. Marla", but Jenna (26), Amanda (24) and Matt (16) also proudly call her "Mom".

From the medical to the personal, Dr. Marla recently opened up to me about her work, her family and herself.

Photo: Tim Leyes, ParentsCanada

This Mom: Let's take advantage of your medical expertise right away to get this interview started! I asked some of my readers what their burning questions for you would be, and one of the most common concerns relates to ear infections. Antibiotics or no antibiotics?

Dr. Marla Shapiro: The recommendations have changed recently, and we now encourage parents not to go for antibiotics. They end up so often in walk-in clinics or situations where an antibiotic is given out too liberally when a lot of what we see is really viral. Many of these ear infections are in fact viral, so we'll tell parents to treat with analgesics for pain management, not so much for fever as fever is not necessarily a bad thing unless it is inhibiting them in some way, and if after 24 to 48 hours they're still not doing well, febrile, pain and so on, we'll elect to go on an antibiotic, but don't be so quick to reach for one.

T.M.: The next one is a very controversial topic: what's your stand on childhood vaccinations?

M.S.: Vaccinations are the biggest improvement to public health after handwashing for prevention of disease, so I'm a pro-vaccine advocate. There is evidence now that there is no link between any vaccines and autism and the safety and efficacy data on the vaccines that we use are excellent, so I am a great pro-vaccinator. I encourage my parents to understand that primary prevention is your best strategy, and this whole concept that getting a disease makes the immune system tougher -- there is no science behind that at all.

T.M.: How do you find technology and internet resources have impacted your practice? Are patients coming in well-informed or misinformed, and what effect does that have?

M.S.: It's a combination. I tell all my patients that knowledge is power, but that self-diagnosis is a very dangerous thing to do. You've got to be very cautious what you're using the internet for, and cautious of the site you're going to, always making sure that it's not a branded site in any way, they're not trying to sell you anything. I encourage my patients to use the internet as a resource when there's something specific they want to do more reading about, but I'm very nervous about patients misdiagnosing themselves and using the internet inappropriately.

T.M.: I just recently read your book, and until then I had no idea that you went through the tragedy of Sudden Infant Death Syndrome with your baby son Jason many years ago. Quite often we see research come about regarding SIDS, for example recently that babies who have died of SIDS have been found to have lower levels of the hormone serotonin. Does information like this help play a role in prevention?

M.S.: There has been so much information where there have been associations, but it doesn't prove causation. There may be some other missing link. As far as where we are with SIDS, the greatest steps that we've taken are in the area of risk-reduction. It was very difficult about 15 or 20 years ago to get parents to start bedding babies on their backs. We had to go through this whole generation where we had grandparents and parents who had already bedded one child on their tummy and didn't have issues with it and truly believed that their child slept better on their tummies. Positioning is really critical, and all the other things we know like breastfeeding, not overheating your child, keeping smoke out of the environment, crib safety...all of those are so important but I think we're still a long way off from knowing what SIDS is. It's one of the few diseases that presents with death as the only symptom. There's no warning sign or anything to look for. We've seen the numbers steadily decline with change to sleep positions, and we still see it more prevalently with boys than we do with girls, it's more common in the fall and winter months which had led a lot of people to think that there's a relationship with some type of virus. It's hard to know.

T.M.: You make the point in your book that when someone is faced with a serious diagnosis, as you were with breast cancer, often well-meaning friends can say or do the wrong thing. Based on your experience, what are some of the right or helpful things that friends and relatives can say or do in that situation?

M.S.: What made me the angriest was people who told me it was going to be okay, because you don't know that it's going to be okay! And you don't want false reassurances. I think what you can do is just acknowledge, and be there for your friend, and understand that reactions are going to change over time. I think for most people, when given any type of life-threatening diagnosis, there's a great deal of fear, and there's anger, and often that's when people come in, at that stage, wanting to reassure you, when you're not in a position to be reassured.

What was important for me was to get all the information, know where I was. I wanted my friends to acknowledge that this was difficult, and not to placate me in any way or try to reassure me when there was no reassurance to be had. It's also important to be there. Instead of trying to solve the problem for someone, which you can't do, what you can do is say to a friend "I'm here for you, I'm here to listen, to keep you company, to just sit with you in silence if that's what you want...or drive your carpool or take the kids to soccer, or get a grocery order for you or prepare a meal..." Something tangible. Those were the things that were most helpful to me. My friends who didn't try to come in and take over my life, but let me know that whatever I needed, they were here, and as difficult as it was for me to accept that at the beginning, it became such a godsend.

T.M.: You're the Editor-in-Chief of Parents Canada magazine - and you gave me my first freelance assignment, by the way - how are you enjoying that role?

M.S.: I really do enjoy it, because I think Parents Canada is very evidence-based, it's not anecdotal. That's important for me, that information be evidence-based and it be reliable, and it speaks to our audience's needs, so that's what we try to do. We try to do it in a creative way, in an educational way, and a way that really meets what we hear from our readers in terms of what they are wanting to hear about and questions they have. I'm enjoying the "Ask Dr. Marla" page. The questions, I think, are very real-life and the type of questions that people ask all the time and it keeps me on my toes listening to our readers. I'm enjoying it quite a bit.

T.M.: As such a well-loved television personality, what do you find are some of the disadvantages of being so recognizable?

M.S.: First of all, I think that it's such a privilege to do what I do. It really is. You build, over years, relationships with your viewers and I know that because they email questions or comments, and the response when I announced I had breast cancer was just so overwhelming. I think that for the most part it's a very positive experience. When is it a negative experience? The odd time when someone doesn't know a boundary and is very intrusive.

When my kids were very little they found it frightening sometimes that strangers would approach me and that they knew my name. When the kids were young, we definitely kept them out of the spotlight. In fact, when I did the documentary I don't think we filmed Matt at all, or allowed him to be on air. One, because he was little and couldn't really make an informed decision as to if this was something he really wanted to do and definitely I was very protective of my children when they were young, keeping them out of the public eye. As my husband would remind me, this is something that I chose to do, not something that the family chose to do or something that the kids chose to do, so at the time when we did the documentary that was a family decision, not my decision alone.

Same thing with the risk reduction tour that I did across Canada for Sudden Infant Death Syndrome. I had not been public about my son's death at all when he died initially. This was a family tragedy, a family event, not something that just happened to me. And it was only in 2000, seven years after Jason died, when Health Canada and the Society for the Study of Infant Death approached me to do the risk reduction tour that we made the decision as a family, as I would be telling the family's story. So it's very very different when it's personal as opposed to when it's professional.

Because you're in people's homes every day, and when we did Balance we were on in reruns forever, people feel like they know you. And they do know a lot about me: what I look like, and what my thinking is. So some people who aren't particularly good with boundaries would think that they knew more than they really do know about me, or felt that they could approach me in a way that was not quite appropriate. That's sort of when you get the downside.

My thanks to Dr. Marla for sharing this family photo

T.M.: Your kids are older now. What are some of the joys that we moms of young children can look forward to as our kids grow up?

M.S.: It's been so interesting. I remember people asking me, "aren't you worried about this, or what is yet to come?" and you do it stepwise. Every day you learn something new about your kids. I see that with my own young moms, worried about the sleep patterns or what they're eating, and I always tell them "By the time you think you've got this thing licked there's going to be something else that's new." It changes, and you never know what the next day's going to bring.

It's been a real joy to see who my children are as people, and to watch them unfold. They're like these flowers that bloom and it's so interesting to see how different they are, the directions they want to go in, and watching them find themselves. It has been at times terrifying, and at times really exciting. You try to sort of calm yourself in the moments of terror when you're thinking "Oh my God, why did they make that decision?" It's hard to let them go. You have to remember as a parent that you can't fight their wars, you can't solve their problems, you're just here to give them the tools so they can do it on their own.

I was just away with my son, who is now 16 years old, on Spring Break. It's so different when you're travelling and you've got little kids, and you're sort of entertaining them and now that he's 16 he's a young adult, so I was really curious about how it was going to go. Jenna is married and is a teacher and doesn't get the same Spring Break, and Amanda is in Boston, so it was just me and Matt. When I would go away with my girls it was one thing but going away with my son one-on-one was really interesting. We have some common interests, we golfed together...my middle one called during the trip and asked "what are you and mom talking about?" and he said "there's lots of things for us to talk about!" It was really entertaining to see this young man spend time with me. It was really special.

You've got to enjoy it all. Even the times that are not so enjoyable, you've got to remember that those too shall pass.

Photo: Caroline Ryan, ParentsCanada

T.M.: How would you complete the sentence "This Mom Loves..."?

M.S.: I love to snowshoe in the winter. I love to find the time to get to the gym and work out. I love to cook and find cooking very therapeutic. During the time I was off for a year with my chemotherapy and my surgeries I mastered baking. I love to read. I love to take one-on-ones with my kids, and the uniqueness of what that's about, when you're not dividing yourself in three.

What else do I love, apart from the obvious things like my family? I love when it's quiet and I have time to myself. I love to travel and speak because I love to get out and meet people, and be able to put a face to who's on the other side of the lens that I don't always get to see.

I think that after you go through an experience where of all a sudden you feel like you need to think about the fact that you can die, because we don't really think about that, it's really taught me to pretty much stay in the moment, and not to think so much about the five-year plan or the ten-year plan. I'm a very organized person, and I'm a very planned person, I have to be with all the things I do. But at the same time, it's taught me to take a little bit of space, and one of the most important things I've learned is how to say no. I am liking the fact that I'm trusting myself to learn when I should say no, and understand what's on the other side of the no. We tend to say yes way too often.

T.M.: Well I appreciate you saying yes to me!

M.S.: It was a pleasure to say yes to you! I think one of the most important things we can do as moms, and I tell this to the moms in my practice, is to share your experiences and stories, and not only the good ones, but the bad ones too. It's so important to recognize that when we think we've done something wrong or we've been a bad parent, we're our own harshest judges, and there's always another opportunity. It's also important to know when you're sorry about something, and to be able to teach that to our children because we're not perfect.

That's why I did choose to speak to you because I think that blogging is such an important way for people to connect, because people do connect over the internet now, and social media has become so important in supporting some of the things we do, so when you find a site that is a reliable site, and an important site that you go back to, you should share your stories there.

This was an outstanding interview! I completely understand her love of having time to herself! Just recently I have felt pulled in so many directions and I have realized how important it is for Moms to take time for themselves! You know what they always say...happy Moms equals happy homes! I plan to do a little more for myself in the upcoming weeks! Thanks for sharing Kate!Krista S.